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Abdominal aortic aneurysm repair - open

AAA - open; Repair - aortic aneurysm - open

Open abdominal aortic aneurysm repair is surgery to fix a widened part in your aorta. This is called an aneurysm. The aorta is the large artery that carries blood to your belly (abdomen), pelvis, and legs.

An
aortic aneurysm
is when part of this artery becomes too large or balloons outward.

Aortic aneurysm

An aneurysm is an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel. A thoracic aortic aneury...

General anesthesia

Your surgeon opens up your belly and replaces the aortic aneurysm with a man-made, cloth-like material.

Here is how it can be done:

In one approach, you will lie on your back. The surgeon will make a cut in the middle of your belly, from just below the breastbone to below the belly button. Rarely, the cut goes across the belly.

In another approach, you will lie slightly tilted on your right side. The surgeon will make a 5- to 6-inch (13 to 15 centimeters) cut from the left side of your belly, ending a little below your belly button.

Your surgeon will replace the aneurysm with a long tube made of man-made (synthetic) cloth. It is sewn in with stitches.

In some cases, the ends of this tube (or graft) will be moved through blood vessels in each groin and attached to those in the leg.

Once the surgery is done, your legs will be examined to make sure that there is a pulse.

The cut is closed with sutures or staples.

Surgery for aortic aneurysm replacement may take 2 to 4 hours. Most people recover in the intensive care unit (ICU) after the surgery.

Why the Procedure Is Performed

Open surgery to repair an abdominal aortic aneurysm is sometimes done as an emergency procedure when there is bleeding inside your body from the aneurysm.

You may have an abdominal aortic aneurysm that is not causing any symptoms or problems. Your health care provider may have found the problem after you had an
ultrasound
or
CT scan
done for another reason. There is a risk that this aneurysm may suddenly break open (rupture) if you do not have surgery to repair it. However, surgery to repair the aneurysm may also be risky, depending on your overall health.

Ultrasound

Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.

High blood pressure

You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), naprosyn (Aleve, Naproxen), and other drugs like these.

Ask which drugs you should still take on the day of your surgery.

Always tell your provider if you have a cold, flu, fever, herpes breakout, or other illness before your surgery.

DO NOT drink anything after midnight the day before your surgery, including water.

On the day of your surgery:

Take the drugs you were told to take with a small sip of water.

You will be told when to arrive at the hospital.

After the Procedure

Most people stay in the hospital for 5 to 10 days. During a hospital stay, you will:

Be in the intensive care unit (ICU), where you will be monitored very closely right after surgery. You may need a breathing machine during the first day.

Have a urinary catheter

Have a tube that goes through your nose into your stomach to help drain fluids for 1 or 2 days. You will then slowly begin drinking, then eating.

Receive medicine to keep your blood thin

Be encouraged to sit on the side of the bed and then walk

Wear special stockings to prevent blood clots in your legs

Be asked to use a breathing machine to help clear your lungs

Receive pain medicine into your veins or into the space that surrounds your spinal cord (epidural)

Outlook (Prognosis)

Full recovery for open surgery to repair an aortic aneurysm may take 2 or 3 months. Most people make a full recovery from this surgery.

Most people who have an aneurysm repaired before it breaks open (ruptures) have a good outlook.